As of early 2026, hospitals or corporate entities employ 82% of physicians — a 5.6 percentage point increase in just two years, according to Avelere and the Physicians Advocacy Institute.
The consolidation has been decades in the making, but the pace is accelerating. Since 2024 alone, hospitals have acquired roughly 5,800 physician practices and corporate entities — primarily private equity firms and insurers — have acquired more than 8,000.
Here is a breakdown of which groups are buying up physician practices, including at what scale, price, and what the results and costs are for physicians in acquired practices.
1. Private practice participation has collapsed. In 2024, only 42.2% of physicians worked in private practice, down from 60.1% in 2012, according to the American Medical Association’s Physician Practice Benchmark Report. Private practice now represents less than half of physicians in most medical specialties, with participation ranging from 30.7% in cardiology to 46.9% in radiology.
2. Corporate entities now own more practices than hospitals. Corporate entities including insurers and PE-backed companies employed 23% of physicians in 2024, up from 15% in 2019, according to a September 2025 Government Accountability Office report. Corporate entity ownership of practices (33.2%) now exceeds hospital ownership (30.6%) — a threshold crossed for the first time as of early 2026.
3. PE’s footprint is concentrated in specific specialties and markets. About 6.5% of physicians worked in PE-owned practices in 2024, up from 4.5% in 2022, per the GAO. In specialties such as gastroenterology, dermatology and ophthalmology, PE involvement exceeds 30%. Hospital-physician consolidation reached 66% in the Midwest and 58% in rural areas in 2024.
4. More than 29,000 physicians became hospital employees in 2025 alone. Since 2024, 48,100 physicians left independent practice and 13,900 additional practices were acquired. In rural areas, independent physicians fell below corporate-employed physicians for the first time in 2024.
5. PE healthcare investment hit an estimated $191 billion in 2025. Private equity investment in healthcare surged in 2025 to an estimated $191 billion, and activity shifted toward larger transactions with more deals exceeding $1 billion and a rebound in exit value, according to a March 2026 VMG Health report. Sponsor-to-sponsor transactions nearly doubled, signaling renewed confidence.
6. Deal values swung dramatically across the year. Healthcare deal value dropped sharply from $19 billion in the fourth quarter of 2024 to $7 billion in the third quarter of 2025, then rebounded to $22 billion in the fourth quarter of 2025. Overall deal volume held steady in the mid-260s to low 300s per quarter throughout the year, according to a PwC report.
7. High-growth subsectors still command premium multiples. ASCs, home infusion and behavioral health are commanding strong multiples due to “perceived scalability and favorable reimbursement direction,” per PwC’s 2026 healthcare mergers and acquisitions outlook. Ophthalmology, oncology, orthopedics and gastroenterology are also drawing intensified investor interest, with gastroenterology commanding premiums supported by strong outpatient endoscopy demand.
8. PE’s strategy is shifting from roll-up to platform. PE firms are moving away from “loose confederations” of practices toward integrated platforms with shared infrastructure and standardized operations, according to Bain & Co.’s “Global Healthcare Private Equity Report.”
9. PE is sitting on $75 billion in uninvested healthcare capital. PE firms reportedly held $75 billion in uninvested capital in healthcare and had owned more than 200 healthcare provider businesses in the U.S. and Canada for at least five years as of early 2025, according to Rebecca Springer, director of market development at Bailey & Co. “There’s just an enormous amount out there that needs to trade at some point,” she said.
10. Hospital acquisitions are consistently followed by price increases. A July 2025 NBER study found that two years after a hospital-physician merger, hospital prices rose 3.3% and physician service prices rose 15.1%, with no measurable improvements in quality. The GAO report also found hospital-physician consolidation is associated with 17% higher commercial office-visit prices. Nearly all of the estimated deal valuations in the NBER study fell below the FTC’s Hart-Scott-Rodino merger reporting thresholds, meaning they proceeded without mandatory federal review.
11. PE acquisitions drive physician turnover. A March 2025 Health Affairs study found the share of physicians leaving PE-acquired ophthalmology practices year over year increased by 13 percentage points — a 265% relative increase — compared to similar unacquired practices. A separate 2026 Health Affairs study of 451 primary care practices found that after PE acquisition, exits increased by 0.22 clinicians per practice, largely driven by advanced practice provider turnover.
12. Optum’s contraction is the market’s clearest cautionary signal. Optum Health spent 2025 scaling back after a period of overexpansion, narrowing its affiliated provider network by nearly 20% and reducing risk-based membership by about 15%. The unit faced an $11 billion headwind over three years tied to federal risk model changes and elevated medical costs. Value-based care membership is expected to decline another 10% in 2026 before recovering. In October 2025, Optum leadership said the organization was “moving to employed or contractually dedicated physicians wherever possible” as it pulled back from broad affiliation arrangements.
13. Physicians in physician-led organizations are far more satisfied. Eighty-one percent of physicians working in physician-led organizations reported satisfaction with their involvement in strategic decision-making, compared with just 50% in hospital-led practices, according to a 2024 Bain & Company survey. The gap underscores the structural tension in corporate acquisition models, where clinical and financial decision-making authority shifts away from physicians.
14. A countercurrent is emerging. A new wave of physicians is returning to the ownership model, driven largely by concerns over autonomy, compensation and burnout.
15. States moved aggressively against consolidation in 2025. State lawmakers enacted 37 bills related to consolidation and competition in 2025, targeting PE oversight, noncompete restrictions and certificate-of-need law revisions. The Hart-Scott-Rodino Act filing threshold rose to $126.4 million in 2025, but more than 35 states now require separate transaction notifications — and some are adopting PE-specific review laws.
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